Individual provider Active NPI

Liston Stephen Jones Jr., MD

  • Internal Medicine Physician
  • Mobile, AL
National Provider Identifier
1639177553
Registry record updated Sep 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
00006675 Issued in AL
Practice address
101 Memorial Hospital Dr
Suite 200
Mobile, AL 36608-1753
Phone
(251) 414-5900
Fax
(251) 281-1162
NPI assigned
Jul 13, 2005
Last updated
Sep 19, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 00006675 AL Primary

Addresses

Primary practice location

101 Memorial Hospital Dr
Suite 200
Mobile, AL 36608-1753

Mailing address

PO Box 160928
Mobile, AL 36616-1928
Phone (251) 414-5900

Other identifiers 3

IdentifierTypeStateIssuer
0410322OtherALUNITED HEALTHCARE
000018020MedicaidAL
051018020OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240716000818 AL Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3971417981

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
00006675ALMDInternal Medicine Physician
6675ALMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Alabama Medical Group, PC Internal Medicine Current Accepting new patients
Internal Medicine Center LLC PastSince Jun 1, 1988 Accepting new patients

Locations

101 Memorial Hospital Dr
Ste 200
Mobile, AL 36608
Phone (251) 414-3079

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316390400000",
    "number": "1639177553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 160928",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366161928",
            "telephone_number": "251-414-5900",
            "fax_number": "251-342-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEMORIAL HOSPITAL DR",
            "address_2": "SUITE 200",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366081753",
            "telephone_number": "251-414-5900",
            "fax_number": "251-281-1162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "LISTON",
        "middle_name": "STEPHEN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2011-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "00006675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0410322",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000018020",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "051018020",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.